title: How does change occur following a theoretically based self-management intervention for type 2 diabetes.
abstract: The purpose of this study was to test the extent that constructs from two theoretical models (self-regulatory theory and social cognitive theory) mediated change in outcomes following a self-management intervention. One hundred and twenty four individuals with type 2 diabetes who had participated in a randomised controlled trial of a diabetes self-management programme were analysed for the extent that illness beliefs and self-efficacy mediated change in self-management behaviours and illness specific quality of life. Exercise specific self-efficacy significantly mediated change in exercise at three months (B = .03; .01, p < .05) while monitoring specific self-efficacy mediated change in monitoring behaviour at both three (B = .04; .01, p < .01) and nine months follow-up (B = 5.97; 1.01, p < .01). Belief in control over diabetes mediated change in illness specific quality of life at three months (B = -.07; .28, p < .05) and nine months (B = .79; .28, p < .01) follow-ups, as well as change in exercise behaviour at immediately post-intervention (B = -.12; .17, p < .05). Behaviour-specific self-efficacy may have a stronger role in mediating self-management behaviours than illness beliefs; however, belief in control over diabetes may be important to manipulate for change in quality of life. This suggests different theoretical constructs may mediate change dependent on outcome.
authors.affiliation: a Centre for Primary Care and Public Health , Barts and the London School of Medicine and Dentistry, Queen Mary University of London , London , UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Steed
authors.forename: Maria
authors.initials: M
authors.lastname: Barnard
authors.forename: Steven
authors.initials: S
authors.lastname: Hurel
authors.forename: Catherine
authors.initials: C
authors.lastname: Jenkins
authors.forename: Stanton
authors.initials: S
authors.lastname: Newman
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011582:Psychological Theory; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D016896:Treatment Outcome
keywords: illness beliefs; mediation; self-efficacy; self-management